Healthcare Provider Details

I. General information

NPI: 1174700595
Provider Name (Legal Business Name): MIM BARTOS OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1780 S BELLAIRE ST STE 270
DENVER CO
80222-4470
US

IV. Provider business mailing address

1780 S BELLAIRE ST STE 270
DENVER CO
80222-4470
US

V. Phone/Fax

Practice location:
  • Phone: 720-464-0397
  • Fax:
Mailing address:
  • Phone: 720-464-0397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number31003646A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0003584
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: